Health-related quality of life in individuals with metabolic syndrome: A cross-sectional study.

INTRODUCTION AND OBJECTIVES: Metabolic syndrome (MetS) is a combination of various cardiovascular risk factors with a major impact on morbidity and premature mortality. However, the impact of MetS on self-reported health-related quality of life (HRQoL) is unknown. This study evaluated the HRQoL in a Spanish adult population aged 55 years and older with MetS. METHOD: A cross-sectional analysis was performed with baseline data from the PREDIMED-Plus multicentre randomized trial. The participants were 6430 men and women aged 55-75 years with overweight/obesity (body mass index ≥27 and ≤40kg/m2) and MetS. The SF-36 questionnaire was used as a tool to measure HRQoL. Scores were calculated on each scale of the SF-36 by gender and age. RESULTS: Participants showed higher scores in the social function (mean 85.9, 95% CI; 85.4-86.4) and emotional role scales (mean 86.8, 95% CI; 86.0-87.5). By contrast, the worst scores were obtained in the aggregated physical dimensions. In addition, men obtained higher scores than women on all scales. Among men, the worst score was obtained in general health (mean 65.6, 95% CI; 65.0-66.2), and among women, in body pain (mean 54.3, 95%CI; 53.4-55.2). A significant decrease was found in the aggregated physical dimensions score among participants 70-75 years old, but an increased one in the aggregated mental dimensions, compared to younger participants. CONCLUSIONS: Our results reflect that the MetS may negatively affect HRQoL in the aggregated physical dimensions, body pain in women, and general health in men. However, this adverse association was absent for the psychological dimensions of HRQoL, which were less affected.

Evaluación de parámetros de calidad de vida y repercusión funcional en pacientes con Síndrome de Fatiga Crónica / Evaluation of health related quality of life and functional impairment parameters in patients with chronic fatigue syndrome

Fundamento: El Síndrome de Fatiga Crónica (SFC) es una enfermedad claramente invalidante que altera la calidad de vida y tiene una marcada repercusión funcional en los pacientes. Objetivos: En pacientes con SFC, valorar: 1)Parámetros de Calidad de Vida Relacionada con la Salud (CVRS) y Repercusión funcional (RF), 2) Grado de afectación con una escala clínica funcional. 3) Presencia e influencia de comorbilidad asociada y 4) Relación de los parámetros de CVRS y RF con los valores poblacionales de referencia (VPR) y con los de un grupo de pacientes de similar edad afectos de artritis reumatoide (AR). Metodología: Trabajo descriptivo transversal con inclusión consecutiva de 100 pacientes afectos de SFC. 1) Estudio de datos epidemiológicos y de situación laboral. 2) Valoración de grado de afectación del SFC en una escala clínica de afectación progresiva (grados I a IV). 3) Valoración de comorbilidades: Fibromialgia, Síndrome seco, Obesidad, Distimia, Disfunción tiroidal, Colon irritable y Endometriosis 4) Valoración de CVRS con el cuestionario genérico validado Medical Outcomes Study Short-Form (SF-36) y de la RF con el cuestionario específico validado Standford Health Assessment Questionnaire (HAQ). 5) Comparación de resultados con VPR y con pacientes afectos de AR. Resultados y conclusiones: El grado de afectación funcional era moderado (II) en la mitad de casos, y leve (I) o grave (III-IV) en un 25% de casos, respectivamente. Existían alteraciones valorables en los índices de puntuación de todas las dimensiones del cuestionario HAQ. En los pacientes con SFC existía una mayor afectación de parámetros de CVRS (SF-36) en comparación tanto con parámetros poblacionales como con pacientes con AR. Las dimensiones más relacionadas con el empeoramiento funcional fueron la Función física, el Rol físico, la Vitalidad, la Función Social y el Rol emocional. Existía una correlación positiva entre la escala clínica de afectación funcional y la mayoría de dimensiones del SF- 36. El índice de incapacidad funcional medida con el HAQ presentaba una alta correlación con las puntuaciones de la dimensión función física del SF-36 y de la dimensión dolor corporal. Se objetivó una media de 2,4 tipos diferentes de co-morbilidad en cada paciente con SFC, existiendo una correlación inversa con las dimensiones de CVRS. Conclusiones: En pacientes con SFC existe una marcada afectación de los parámetros de CVRS y RF, superior a los parámetros poblacionales e incluso a los de pacientes afectos de AR. La presencia de comorbilidad supone un mayor empeoramiento funcional. El empleo de una escala clínica de afectación progresiva es útil en la valoración funcional de estos pacientes. Para mejorar potencialmente la CVRS en pacientes con SFC deberá incidirse en modificar las dimensiones afectadas, sobre todo la función física, el dolor corporal y el tratamiento de las comorbilidades

Background: Chronic Fatigue Syndrome is a disabling disease that modifies the quality of life and supposes a marked functional impairment of patients. Aim of Study: In patients with CFS, to evaluate: 1) Health-related quality of life (HRQL) and Functional impairment (FI) parameters, 2) Gradation of FI with a clinical scale. 3) Presence and influence of comorbidity related to CFS, and 4) Relationship between HRQL and FI parameters in CFS with standard population values, and with values form a group of patients of similar age affected of Rheumatoid Arthritis (RA). Patients and Methods: Cross-sectional study with consecutive inclusion of 100 patients affected of CFS. Evaluation of: 1) Epidemiological data and work situation at diagnosis. 2) Function impairment evaluation with a clinical scale of progressive involvement (degrees I to IV). 3) Evaluation of comorbilities: Fibromyalgia, Sicca Syndrome, Obesity, Dysthymia, Thyroid dysfunction, Irritable Bowel Syndrome and Endometriosis 4) Evaluation of HRQL with the validated Medical Outcomes Study Short-Form (SF-36) questionnaire and evaluation of FI with the specific Standford Health Assessment Questionnaire (HAQ). 5) Comparison of results in CFS with those of general population and also with patients affected of RA. Results: In CFS, the functional impairment was moderate (II) in half of patients, and slight (I) or severe (III-IV) in a quarter, respectively. All dimensions of HAQ questionnaire were affected. HRQL parameters measured with SF-36 questionnaire were more affected in patients with CFS as compared to standard population values as well as in comparison to patients affected of RA. The dimensions mainly related to FI were physical function, physical role, vitality, social function and emotional role. There was a direct relationship between the clinical functional scale and most of the SF-36 dimensions. The function disability index measured by HAQ highly related with values of physical role and body pain from SF-36 questionnaire. Patients with CFS presented a mean of 2.4 different types of comorbidity, with an inverse relationship with HRQL dimensions. Conclusions: In patients with CFS there is a clear decrease of HRQL and FI parameters, with significantly lower values as compared to standard population and also to patients with RA. The presence of co morbidity supposes a major degree in functional disability. A clinical scale evaluating progressive degree of involvements was useful in the functional evaluation of patients with CFS. To potentially improve the HRQL and FI in patients with CFS we should address to modify those dimensions clearly affected, mainly physical function, body pain as well as treatment of comorbidities

[Analysis of the new active principles sold in Spain (1992-2002)]. / Análisis de los nuevos principios activos comercializados en España (1992-2002).

OBJECTIVES: To describe the active principles (AP) marketed in Spain from 1992 to 2002, to determine their characteristics, and to find whether they supposed genuine therapeutic advances (TA). DESIGN: Transversal, descriptive study. MAIN MEASUREMENTS: The degree of TA in the AP analysed was studied with the classification used by the FDA (A*: exceptional therapeutic novelty; A: important therapeutic novelty; B: modest therapeutic improvement; C: null or very little therapeutic improvement, corresponding to "me-too" drugs; and D: not classified), the context of use and the price. RESULTS: 369 new AP were marketed. 3.5% were in group A*, 11.9% in A, 30.1% in B, 49.3% in C, and 5.1% in D. 42.3% corresponded to AP used in hospitals for therapy or diagnosis. Significant differences were found (P<.05) on comparing the degree of TA and the context of use, such that more AP in the A/A* (32.6%) and B (44.0%) groups were found in AP used in hospital therapy and diagnosis than in AP used in primary care and generally (5.3% in the A/A* groups and 23.4% in group B). Only 11 AP of the A/A* groups were used in primary care. The cost per defined daily dose was 17.6 euros; and the new AP in group C were dearer than already existing alternatives in 93.4% of cases. CONCLUSIONS: Real TA are few in number and preferentially used in hospitals. Almost all the new AP are "me-too" drugs and are dearer than already existing alternatives.

[Accidents with biological material in health care workers in 2 primary health care areas (1990-1999)]. / Accidentes con material biológico en trabajadores sanitarios de 2 áreas de atención primaria (1990-1999).

OBJECTIVE: To find out the exposures with biological material in health care workers in primary health care, registered in the biological accidents database from Preventive Medicine Service in Miguel Servet Universitary Hospital of Zaragoza. DESIGN: Descriptive study of a retrospective cohort. SITE: Primary health care, Areas II and V of Zaragoza.Participants. Workers in this areas, distributed by: physician, nursing staff, auxiliary, orderly, housekeeping staff, others. MEASUREMENTS AND MAIN RESULTS: Data of: workers, accident, serologic source, worker protection and vaccinal status of hepatitis B. The incidence of accidents was 26 (period 1997-1999). Most proportion of accidents were declared by nursing (78%). The highest occupational incidence was in auxiliary (63 ). In 90,1% of the cases, the accident was needlestick injury. The source was known in 67,7% of cases. The accidents occurred in hands in 96,8% of cases, and only one third of workers carried gloves. CONCLUSIONS: Results obtained are similar with previous studies about this event. We must insist on the need to declare these accidents, providing more information and accessibility for the declaration to worker. Moreover, we must insist on the correct application in the health care field of the standard precautions, because almost 50% of accidents are evitable, and to increase hepatitis B vaccination covertures.